Ebola is outstripping control efforts, top WHO official warns

If Ebola takes hold in Lagos, Nigeria, it would be disastrous, expert warns

Fears rose Friday that the Ebola virus may have spread as Nigerian authorities said they have quarantined two people who may have the disease and have another 69 under observation.

With fears the disease may get a toehold in Nigeria’s most populous city, Lagos, the head of the World Health Organization warned that the virus in West Africa was outstripping efforts to control it.

Dr. Margaret Chan was speaking at a meeting of the leaders of four West African countries in Conakry, the capital of Guinea, to discuss measures to bring the disease under control. The WHO said it planned to release $100 million to deploy hundreds of medical staff to fight the disease.

More than 1,300 people have been infected in the West African countries of Guinea, Sierra Leone and Liberia in the worst Ebola outbreak on record. Of those, 729 have died, according to the WHO.

In recent weeks the epicenter of the outbreak has shifted from Guinea to Sierra Leone.

"This outbreak is moving faster than our efforts to control it. If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives but also severe socioeconomic disruption and a high risk of spread to other countries," Chan said. “This meeting must mark a turning point in the outbreak response.”

In Nigeria, authorities insisted they had the situation under control after a Liberian, Patrick Sawyer, 40, became ill with Ebola while flying into the commercial capital, Lagos, and later died there in a hospital. The spread of the disease to Lagos has raised fears that cases may emerge farther afield in other parts of Africa, Europe, the United States or elsewhere.

The immediate worst-case scenario would be for the disease to take hold in Lagos – crowded, poverty-stricken in many areas, and at times chaotic, posing the risk it could spread throughout Africa’s most populous country.

“It would be foolish for us to think it couldn’t spread. I think this is a potential worldwide threat,” said Ebola expert G. Richard Olds, dean of the School of Medicine at UC Riverside, noting that in past outbreaks of highly infectious diseases, including SARS, AIDS and monkey pox, the diseases eventually reached the U.S.

“If it takes hold in Nigeria, we have a real problem on our hands. I’d be very concerned about that because Lagos would be the most concerning situation: It’s a very densely populated area and is in a situation where the healthcare infrastructure is probably ill prepared to deal with this type of virus.”

The chief medical officer of the Lagos Teaching Hospital, Akin Osibogun, said the hospital had tested 20 blood samples for possible Ebola cases, all of which tested negative, Nigerian media reported Friday.

However, there were signs of panic and chaos. A man’s corpse was brought into Anambra state in recent days as cargo from Liberia, underscoring doubts about whether adequate measures are in place to control the disease. The cause of the man’s death wasn’t known.

Authorities on Thursday cordoned off the morgue where the body was being held.

“We are surprised how the corpse came into Nigeria and Anambra state. It is shocking to us,” a local health official, Josephat Akabike, told Vanguard newspaper. “We have directed the police to cordon off the area. Ebola is a very big threat and that is why we are taking all the measures.”

Uganda, Kenya and South Africa all said Friday they had no suspected cases of the disease.

South African authorities warned they would not allow anyone into the country who knowingly arrived with the Ebola virus -- but said they would admit and treat anyone who arrived with symptoms if they were not aware they had the disease. The country has thermal scanners at airports capable of detecting people with elevated temperatures.

Ebola initially presents with common, flu-like symptoms -- fever, headache and body aches. The disease, while highly contagious, is not airborne and is transmitted through contact with bodily fluids, including sweat and blood.

The terror in West Africa has hampered efforts to control it, with people running away rather than going into isolation wards, which are associated with death.

In her remarks, Chan said it was important to combat the popular view that Ebola was a certain death sentence, which impeded efforts to get people to seek help in hospitals and treatment facilities. People instead keep their loved ones hidden at home or turn to traditional healers, causing the virus to spread.

She warned that “public attitudes can create a security threat to response teams when fear and misunderstanding turn to anger, hostility, or violence."

Chan also said it was also important to change cultural attitudes around burial.

For relatives of victims, washing and burying the body is culturally important, but also highly dangerous and one way in which the disease has spun out of control.

Olds said that while the disease has a high fatality rate – more than 50% - and was highly contagious, it is not as contagious as SARS, because it is not an airborne virus.

Previous outbreaks had occurred in remote areas of Africa, where the population wasn’t mobile, making it easier to contain, but this outbreak occurred in a more densely populated region with a highly mobile population, accounting for the rapid spread of the disease and difficulties containing it.

“It’s particularly dangerous when it gets into areas that are densely populated and have weak health infrastructure,” he said.